One of the very common negative effects experienced by operators and workers of sewing machines is neck pain. The use of sewing machines in a forward-leaning position over an extended period of time contributes to neck strain and promotes bad postures like the Forward Head Posture (FHP). The objective of this study was to determine the prevalence of FHP and neck pain among sewing machine operators in tailors and garment factories of District Swabi, Pakistan. This cross-sectional study was carried out on a total of 223 users of sewing machines while seated (97 women and 126 men). The study was conducted in Swabi District from October 2022 to February 2023. The outcomes were evaluated using a numerical pain rating scale and the Neck Disability Index (NDI). According to the Numerical pain Rating Scale (NPRS) for neck pain, 24 participants (10.8%) reported mild discomfort, 79 participants (35.4%) reported moderate pain, and 120 participants (53.8%) reported severe pain. Only 13.9% (n=31) of the participants (n=192) had a normal head position. The majority of the participants were hunched forward. The NPRS had a mean of 3.43 (± SD 0.49), the NDI mean was 3.43 (± 0.68), and the cranial vertebral angle (CVA) mean was 1.13 (±SD 0.34). According to the findings of the current study, FHP and neck pain are quite common among individuals who use sewing machines, and a large percentage of these people also have FHP and neck discomfort.